《保险研究》20241108-《农村社会养老保险对居民健康行为影响的理论和实证研究》（周钦、田森、王梦潇、潘杰）

［摘   要］本文在理论层面分析了养老保险对健康行为影响的三个机制，包括收入效应（未来收入的增加）、时间偏好效应（远期消费的边际效用提升），以及承诺工具（强制进行长期投资），并利用2011年和2013年中国健康与养老追踪调查（CHARLS）数据，采用工具变量方法估计农村社会养老保险对居民健康行为的影响，发现养老保险减少了农村居民吸烟和激烈活动等“有害”健康行为，促进了合理饮食、更长的夜间睡眠等“有益”健康行为。研究结果意味着，尽管人们对生命价值的主观评估往往无限高——“生命无价”，但在健康水平权衡中表现出的实际健康行为选择确实受到了经济的激励影响——“生命有价”。相应社会保障政策的制定应充分考虑对居民健康行为的引导和激励，以及潜在的社会福利效应。

［关键词］农村社会养老保险；健康行为；健康资本；Grossman健康需求理论

［基金项目］本文得到国家社会科学基金项目“中国城乡居民医保整合下的不公平测度及影响机制研究”（17CGL051）资助。

［作者简介］周钦，中国人民大学公共管理学院副教授，研究方向：健康经济学、社会保障；田森（通讯作者），西南财经大学中国行为经济与行为金融研究中心讲师，研究方向：行为经济学、产业经济学；王梦潇，西南财经大学公共管理学院讲师，研究方向：健康经济与政策分析；潘杰，四川大学华西公共卫生学院/华西第四医院教授，研究方向：卫生政策与经济研究。

Theoretical and Empirical Analysis on the Effect of Social Pension Program on Health Behavior in Rural China

ZHOU Qin,TIAN Sen,WANG Meng-xiao,PAN Jay

Abstract：This paper explores on the impact of social pension program on health behaviors.From the theoretical perspective,we find three mechanisms underlying the impact of pension program on health behaviors,including the income effect (increase of future income),the time preference effect (increase of marginal utility of long-term consumption),and the commitment tool (forced long-term investment).Applying the Instrumental Variable method,we use data from the China Health and Retirement Longitudinal Study (CHARLS) in year 2011 and 2013 to estimate the impact of pension program on the health behaviors of rural residents,and find that the social pension program significantly reduces the “harmful” health behaviors of enrollees such as smoking and intense physical activities,and meanwhile promotes “beneficial” health behaviors such as reasonable diet and adequate night sleep.Our findings suggest that although people’s subjective assessment of the life value is often infinitely high-“life is priceless”,their actual health behaviors are indeed influenced by economic incentives-“life is valuable”.Hence,government should give full considerations to the guidance and encouragement of residents’ health behaviors and the associated potential social welfare effects in the policy making of corresponding social security policies.

Key words：social pension insurance;health behavior;health capital;Grossman’s Model of Demand for Healthcare and Health